Many teens not getting comprehensive sex ed
Many teens not getting comprehensive sex ed
When adolescent patients enter your exam room, be prepared for them to possess limited, inaccurate, or no knowledge of contraception. According to a just-released study, one school district in three forbids dissemination of any positive information about contraception, regardless of whether students are sexually active or at risk of pregnancy or disease.1
Among the seven in 10 public school districts that have a districtwide policy to teach sexuality education, 86% of them require that abstinence be promoted as the preferred or only option for teens. According to the nationally representative sample of 825 school districts, 51% have what is known as an abstinence-plus policy, which promotes abstinence as the preferred option for teens, yet allows contraception to be discussed as effective in protecting against unintended pregnancy, sexually transmitted diseases (STDs), and HIV.1 A total of 35% of districts report they adhere to an abstinence-only policy, where teens are taught that abstinence is the only option outside of marriage.1
"What this is saying is that at least one-third of students are receiving information about contraception that is extraordinarily limited, where either discussion of contraception is barred altogether or the emphasis is on its ineffectiveness in preventing pregnancy and guarding against sexually transmitted diseases," observes David Landry, senior research associate at the Alan Guttmacher Institute in New York City and lead author of the study. "It is very important that providers fill in an essential gap that is not provided by many schools."
A national survey of public secondary school principals by the Kaiser Family Foundation of Menlo Park, CA, gives further insight in the limited education presented in public schools.2
While 94% of public secondary schools discuss abstinence as part of their sex education and most cover HIV and other STDs, fewer than half say they provide information about where to get and how to use birth control and condoms. As many as one in two school programs do not discuss more controversial topics, such as abortion and sexual orientation, in their sex education curricula, the report reveals.
More than eight of every 10 Americans believe young people should receive information to protect themselves from pregnancies and STDs, as well as about abstinence, according to national research by the Washington, DC-based Advocates for Youth and the New York City-based Sexuality Information and Education Council of the United States (SIECUS).3 Ninety-three percent of all Americans support the teaching of sex education in high schools, while 84% support sex education in middle/junior high schools, the study reveals.
While debate continues to surround the teaching of sexual health, the SIECUS study shows that most Americans understand that both abstinence and comprehensive sexual health information can be presented, says Monica Rodriguez, SIECUS director of information and education.
"Parents understand that you can teach young people about abstinence, but you can also teach them about contraception and the things they need to know to protect themselves from STDs and HIV infection," asserts Rodriguez. "In fact, they want their young people to have that information."
Studies have shown that adolescents want more accurate information about sexuality, says Landry. "In many cases, unfortunately, students are not receiving it in the public schools, and they need a source that they can trust and that is reliable. Providers can help fill that void."
At its December 1999 interim meeting, the Chicago-based American Medical Association’s House of Delegates accepted a report by its Council on Scientific Affairs that calls for comprehensive sex education. The report concluded that abstinence-only programs "are of very limited value and require additional, rigorous evaluation before they can be supported as a method for changing students’ risky practices."4
Providers can get involved by obtaining copies of their local school district’s sex education curricula and checking them for accuracy, offers Anita Nelson, MD, professor in the obstetrics and gynecology department at the University of California in Los Angeles (UCLA) and medical director of the women’s health care clinic and nurse practitioner training program at Harbor-UCLA Medical Center in Torrance. "The medically incorrect statements included in typical abstinence-only programs are amazing, [so] offer to be the local expert," she says. "It’s an effective way to influence the education the next generation receives."
References
1. Landry DJ, Kaeser L, Richards CL. Abstinence promotion and the provision of information about contraception in public school district sexuality education policies. Fam Plann Perspect 1999; 31:280-286.
2. Kaiser Family Foundation. Kaiser Family Foundation National Survey of Public Secondary School Principals: The Politics of Sex Education. Menlo Park, CA; December 1999.
3. Sexuality Information and Education Council of the United States. Public Support for Sexuality Education Reaches Highest Level. New York City; June 2, 1999.
4. Shelton DL. Does sex ed focused on abstinence work? AM News Jan. 17, 2000.
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